Recommended Consent Letter for Children Travelling Abroad

The following sample consent letter, provided by Foreign Affairs, Trade and Development Canada, can be modified to meet your specific needs.

To whom it may concern,
I / We, / ,
full name(s) of parent(s) / person(s) / organization giving consent
Address:
street address, city
province/state, country
Telephone and email:
telephone / email
am / are the parent(s), legal guardian(s) or other authorized person(s) or organization with custody rights, access rights or parental authority over the following child:
Information about travelling child
Name:
child’s full name
Date and place of birth:
dd/mm/yyyy / city, province/territory
Number and date of issue of passport (if available):
number / dd/mm/yyyy
Issuing authority of passport (if available):
country where passport was issued
Birth certificate registration number
number
Issuing authority of birth certificate
province / territory where birth certificate was issued
Information about accompanying person
This child has my / our consent to travel with
Name: / Ariane Carriere
full name of accompanying person
Relationship to child: / Rotarian chaperone
mother, father, grandparent, sister, brother, relative, friend, other
Number and date of issue of passport:
number / dd/mm/yyyy
Issuing authority of passport: / Canada
country where passport was issued
Contact information during trip
I / We give our consent for this child to travel to:
Destination(s): / Guatemala
name of destination country / countries
Travel dates: / March 13-21, 2016
date of departure to date of return
to stay with / at (if applicable) / Familias de Esperanza
name of person with whom child will be staying / hotel or other accommodation
at the following address(es) / Km2, Carretera a San Juan
street address(es), city (cities)
Antigua, 03901 Sacatepéquez, Guatemala
province(s)/state(s), country (countries)
Telephone and email / 011-502-7-922-6600 /
This letter may be signed before a witness who has attained the age of majority (18 or 19, depending on the province or territory of residence) OR certified by an official who has the authority to administer an oath or solemn declaration (recommended).
Signature(s) of person(s) giving consent / Signature of witness / or / Signature of official
Signed before me on this
full name of witness
day of / , / ,
month / year
signature(s) of person(s) giving consent / signature of witness / by
name(s) of person(s) giving consent
dd/mm/yyyy / dd/mm/yyyy / city, province/territory
signature of official
name / title of official

Questions regarding information in this consent letter should be directed to the person(s) or organization giving consent.

(seal)